Assessment of safety of retropupillary iris-claw intraocular lens as a viable option in surgical aphakia

• Main Authors: Minal Doulatramani, Renu Magdum, Rupali Maheshgauri, Radhika Paranjpe
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Medical Journal of Dr. D.Y. Patil Vidyapeeth
• Subjects: aphakia; disenclavation of haptic; iris-claw lens; posterior capsular rupture; retropupillary fixation
• Online Access: http://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2021;volume=14;issue=3;spage=297;epage=302;aulast=Doulatramani

Background: Aphakia is the most dreaded and inadvertent complication of cataract surgery. Visual rehabilitation with wide variety of surgical options is a challenge for the ophthalmologist. Our study evaluates the safety and efficacy of the retropupillary implantation of the iris-fixated intraocular lens (IOL) in a 2-month follow-up period. Aims: This study aims to assess the visual outcome, identify complications, and assess the long-term stability of eyes undergoing retropupillary iris-claw lens implantation for aphakia. Settings and Design: This was a prospective interventional study (single-group, before–after study). Materials and Methods: Sixty eyes with surgical aphakia fulfilling the inclusion criteria were considered. Preoperatively, evaluation of visual acuity, slit-lamp examination, fundus examination, intraocular pressure, corneal endothelial cell count, macular thickness, and edema was done. Anterior vitrectomy was done, and retropupillary iris-claw lens was implanted. Postoperative best-corrected visual acuity (BCVA), IOP, corneal endothelial cell density, macular edema, and IOL stability were evaluated. Statistical Analysis: The computer software statistical package for the social sciences, version 20.0 (SPSS) was used, and a 0.05 level of significance was considered. Results: The major cause of aphakia was posterior capsular rupture (55%). Postoperative BCVA on day 60 was 6/6–6/18 in 83.33% of cases. Three patients had disenclavation of the haptic which required retucking of IOL. No patient had corneal decompensation, cystoid macular edema, or IOP rise. Conclusion: Our results demonstrate that retropupillary technique of iris-claw implantation is a safe and effective method for visual rehabilitation in aphakic patients. This surgical procedure has an advantage of posterior chamber implantation with a low intraoperative and postoperative complication profile.